The MAC began coverage on Jan. 1, 2015, the same day a new Category I CPT Code became available for the procedure. Here are three quick facts:
1. Noridian covers 9 million Medicare beneficiaries, who now have access to minimally invasive SI joint fusion coverage.
2. Noridian covers patients in Alaska, Arizona, California, Hawaii, Idaho, Montana, Nevada, North Dakota, South Dakota, Oregon, Utah, Washington and Wyoming.
3. Now that Noridian announced coverage, three of the eight Medicare Administrative Contractors cover MIS SI joint fusion.
“More high quality clinical evidence is coming very soon [for MIS SI joint fusion] and as a result, we believe that the remaining five MACs will give genuine consideration to covering SI joint fusion,” said Vice President of Health Outcomes and Reimbursement at SI-BONE Michael Myrda.
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